Title

Patient satisfaction with communication from hospitalists in an acute care setting.

Date of Award

5-1-2015

Document Type

Dissertation

School

Caspersen School of Graduate Studies

Degree Name

Doctor of Medical Humanities

Abstract

Background: As the use of hospitalists increases, health care reimbursement is transitioning from a fee-for-service model to a quality-of-care model, and patient satisfaction with communication is a priority. There has been little research assessing factors associated with patient satisfaction with hospitalist communication. Objective: This study examined demographic and clinical factors related to patient satisfaction with communication with a hospitalist team in an acute care setting. Methods: This study of 75 patients was conducted at a not-for-profit, level 1 regional trauma center in northern New Jersey. The association between demographic characteristics (gender, age, and ethnicity) and clinical characteristics (length of stay (LOS), primary care provider (PCP) relationship, number of hospitalists seen, and diagnostic group) and patient satisfaction with communication were examined. Patient satisfaction with communication from hospitalists was measured using a communication assessment tool (CAT-T). The Kruskal-Wallis test was used to identify differences in median CAT-T scores by demographic and clinical factors. A multivariate linear regression model was performed to examine the contribution of each of the independent variables to CAT-T score. A Mann-Whitney U-test was applied to further analyze satisfaction with communication and LOS. To assess the association between satisfaction with communication and satisfaction with medical care, a Pearson correlation was computed. Results: Demographic variables did not contribute to patient satisfaction with hospitalist communication. There were no significant differences in communication satisfaction based on whether patients had a PCP or the number of hospitalists with whom there was communication. A multivariate regression analysis was utilized to examine the contribution of the demographic and clinical variables to the CAT-T total score. The only significant predictor of satisfaction in the regression analysis was diagnostic category. Individuals with surgical diagnoses (n = 17) reported less satisfaction with communication than those with medical diagnoses. There was a significant difference by LOS, with patients with longer lengths of stay being more satisfied. There was a positive linear relationship between satisfaction with communication and satisfaction with medical care (r = 0.863, p<0.001). Conclusions: Based on the results of this study, patients seem satisfied with hospitalist care. Because a shorter LOS was related to overall fewer excellent interactions with communication from hospitalists, clinicians should focus on establishing rapport early in the hospital stay.